Research finds that taking ACE inhibitor medication to control high blood pressure can severely worsen symptoms of oral allergy syndrome, to the point of bringing on anaphylaxis.
When individuals who have OAS take drugs known as ACE inhibitors, which work by slowing an enzyme that helps constrict blood vessels, they may experience facial swelling and difficulty breathing after eating fresh fruit, according to the case studies research. The study was published in the Journal of Clinical Hypertension.
This is due to a “priming effect” of the ACE inhibitors: once the system of an allergic person is “primed” by the drugs, that person will then experience a stronger reaction than usual when re-encountering their allergen.
One of the patients in the study had been on the ACE inhibitor lisinopril for 10 years. Then eating a raw apple landed her in the hospital with a serious allergic reaction. A second patient on the same drug experienced severe tongue swelling on three occasions. That patient had eaten jackfruit and cashews.
ACE Inhibitors and Severe Reaction
“When a sufferer’s allergies are primed and they come in contact with a particular allergen, they experience a more severe than normal reaction,” says lead study author. Dr. Denisa Ferastraoaru. The assistant professor at New York’s Albert Einstein College of Medicine notes that “these reactions can be dangerous.”
Roughly one-third of North Americans who have pollen allergies also have oral allergy syndrome. They will get allergy symptoms, such as itching and swelling of the mouth, lips, face, tongue or throat, after eating fresh fruit such as apples, bananas or melons, and this occurs because of structural similarities in the proteins of the pollens and fruits.
The proteins are so similar that the immune system considers them to be the same and responds to the fruit protein as if it were the pollen protein, leading to a reaction.
Typical symptoms include an itchy palate and throat and swollen lips; life-threatening reactions are far less common with OAS. However, as the research warns, when ACE inhibitors are part of the equation, OAS symptoms can become much more severe.
The study says cardiologists and other health providers need to watch out for OAS allergies in patients with high blood pressure. They need to be assessed to see whether they need to avoid ACE inhibitors.
The authors suggest some patients may manage through taking precautions, such as avoiding trigger foods and carrying epinephrine auto-injectors. Others, however, may be better off with a different prescription medication.
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All About Oral Allergy Syndrome
